中国社区医师
中國社區醫師
중국사구의사
Chinese Community Doctors
2014年
16期
34-35
,共2页
2型糖尿病%肾病%临床治疗
2型糖尿病%腎病%臨床治療
2형당뇨병%신병%림상치료
Type 2 diabetic%Nephropathy%Clinical treatment
目的：探讨2型糖尿病合并肾病临床治疗方法和疗效。方法：2013年2月-2014年2月收治2型糖尿病合并肾病患者40例，总结其临床特点，比较与非糖尿病肾病的区别。治疗时降糖药均选用普通胰岛素，每天餐前30分钟肌注。在此基础上，将患者分两组，分别加用吡格列酮和二甲双胍(治疗组)和单纯应用吡格列酮(对照组)治疗，治疗4个月，治疗前后分别测定24小时尿白蛋白排泄率、肾功等，比较疗效。结果：2型糖尿病合并肾病患者比非糖尿病肾病蛋白尿出现时间早，总胆固醇、甘油三酯值低，24小时尿蛋白定量和肾小球滤过率差异不明显。治疗后，两组FBG、HbA1c、LDL-C、Fib、UAER等降低明显，HDL-C、ISI水平提高，ALT、Cr无显著变化，说明治疗组肾保护功能强，与对照组比较，差异有统计学意义。结论：2型糖尿病合并肾病与非糖尿病肾病病理特点有明显不同，临床应自行鉴别。治疗时，吡格列酮和二甲双胍联合应用疗效显著，更适合临床应用。
目的：探討2型糖尿病閤併腎病臨床治療方法和療效。方法：2013年2月-2014年2月收治2型糖尿病閤併腎病患者40例，總結其臨床特點，比較與非糖尿病腎病的區彆。治療時降糖藥均選用普通胰島素，每天餐前30分鐘肌註。在此基礎上，將患者分兩組，分彆加用吡格列酮和二甲雙胍(治療組)和單純應用吡格列酮(對照組)治療，治療4箇月，治療前後分彆測定24小時尿白蛋白排洩率、腎功等，比較療效。結果：2型糖尿病閤併腎病患者比非糖尿病腎病蛋白尿齣現時間早，總膽固醇、甘油三酯值低，24小時尿蛋白定量和腎小毬濾過率差異不明顯。治療後，兩組FBG、HbA1c、LDL-C、Fib、UAER等降低明顯，HDL-C、ISI水平提高，ALT、Cr無顯著變化，說明治療組腎保護功能彊，與對照組比較，差異有統計學意義。結論：2型糖尿病閤併腎病與非糖尿病腎病病理特點有明顯不同，臨床應自行鑒彆。治療時，吡格列酮和二甲雙胍聯閤應用療效顯著，更適閤臨床應用。
목적：탐토2형당뇨병합병신병림상치료방법화료효。방법：2013년2월-2014년2월수치2형당뇨병합병신병환자40례，총결기림상특점，비교여비당뇨병신병적구별。치료시강당약균선용보통이도소，매천찬전30분종기주。재차기출상，장환자분량조，분별가용필격렬동화이갑쌍고(치료조)화단순응용필격렬동(대조조)치료，치료4개월，치료전후분별측정24소시뇨백단백배설솔、신공등，비교료효。결과：2형당뇨병합병신병환자비비당뇨병신병단백뇨출현시간조，총담고순、감유삼지치저，24소시뇨단백정량화신소구려과솔차이불명현。치료후，량조FBG、HbA1c、LDL-C、Fib、UAER등강저명현，HDL-C、ISI수평제고，ALT、Cr무현저변화，설명치료조신보호공능강，여대조조비교，차이유통계학의의。결론：2형당뇨병합병신병여비당뇨병신병병리특점유명현불동，림상응자행감별。치료시，필격렬동화이갑쌍고연합응용료효현저，경괄합림상응용。
Objective:To explore the clinical treatment methods and curative effect of type 2 diabetic combined with nephropathy. Methods:40 cases with type 2 diabetic combined with nephropathy were selected from February 2013 to February 2014.The clinical characteristics were summaried,and compared with non diabetic nephropathy.The hypoglycemic drugs for treatment were all insulin.It was intramuscular injected 30 minutes before meals every day.On this basis,the cases were divided into two groups. They were treated with pioglitazone combined with metformin(the treatment group) and the simple application of pioglitazone treatment(the control group).They were treated for 4 months.24 hours urinary albumin excretion rate and renal function were respectively measured before and after the treatment.The curative effects were compared.Results:The occurrence time of proteinuria of patients with type 2 diabetic combined with nephropathy was earlier than that of the non-diabetic renal disease.The total cholesterol and triglyceride values were lower than those of the non-diabetic renal disease.The differences of 24 hours urinary protein quantitative and glomerular filtration rate were not obvious.After the treatment,FBG,HbA1c,LDL-C,Fib,UAER of the two groups decreased significantly.HDL-C,ISI level were increased.ALT,Cr had no significant change.The renal protection function of the treatment group was strong.Compared with the control group,the difference has statistical significance.Conclusion:The pathological characteristics between type 2 diabetic combined with nephropathy and non diabetic nephropathy are significantly different.They should self identification in clinical.During the treatment,pioglitazone combined with metformin has a obvious curative effect.It is suitable for clinical application.
